At this point, it was felt that a thorough examination of the lesion for abnormal systemic vascular supply could prove or disprove sequestration as the etiology of this lesion. Angiography was considered, but the patient was referred for multislice CT (MSCT) instead (see below).
Figure 5. MSCT
MSCT was performed using a high rate of contrast injection and repeated imaging through the mass in the early, mid, and late arterial phases as well as venous phase. This examination again showed a heterogeneously enhancing mass as well as very prominent mediastinal vessels, but no systemic arterial supply, arguing against sequestration as the cause of the mass.
Find three enlarged vessels in the posterior part and one in the anterior part of the mass.
Note the basal atelectasis of the lungs bilaterally and the chest tube on the left (signet ring).
Multislice Helical CT (MSCT): MSCT represents the most recent advance in helical CT technology. MSCT allows for the simultaneous, rapid acquisition of multiple narrowly collimated images for every revolution of the x-ray tube, whereas single slice helical CT scanning allows for the acquisition of only one image per tube rotation. Therefore, MSCT scanning allows the entire thorax to be rapidly scanned using thin sections, providing superior spatial resolution with a shorter imaging time, as well as the ability to image patients during various phases of contrast enhancement (i.e., early and later arterial phase, venous phase, etc).
See Figure 6. Return to Unknown 9.
Three vessels in the posterior part of the mass
One vessel in the anterior part of the mass